Keywords

Background

In community public health antiretroviral therapy (ART) programs, HIV-1 viremia in patients has been reduced over the last decade through improved drug regimens, adherence, and genotypic testing to manage ART. However, a large portion (up to 25%) of ART patients remain viremic with risk of disease progression and community-level transmission of drug resistance mutations. We hypothesized that HIV-1 viral evolutionary rate (vEvol) during incomplete suppression of HIV-1 RNA is associated with ART use, selection of drug resistance, and viral load.